Negative smear but biopsies abnormal

hi, I had my first ever smear test earlier this year at the age Of 24. The test came back fine, negative, no abnormalities etc. however, as I bled quite a lot during the test I was referred for a colposcopy. They took 3 biopsies from my cervix and the results came back with severe abnormalities, cin3. I have just had the lletz treatment today to get rid of these and if the results come back clear I will just have a follow up smear in 6 months time. My concern is however that my smear test didn't pick up these abnormalities last time around so how can I be sure they will in any future smears. It took a biopsy to show this so I would have thought i would need biopsies in the future too. I will never trust another smear test result now that comes back as normal Because of this experience, which is very worrying. Does anyone else have experience of this? I don't think it will be as simple as - just tell them you want biopsies each time, as they can't keep taking pieces of my cervix away especially after lLetz. Do I have to just hope this was a one off? 

Hi Precious,

The problem with smears is that they're not fool-proof, and it's good you were referred due to the bleeding. Smears only capture some cells from the tranformation zone, which is where changes are most likely to occur. They can depend on the skill/experience of the person doing it, and chance as to whether abnormal cells are picked up. I've always felt that the best smears are when it feel like the nurse is digging for gold and then I've felt like they're getting a good sample. (Sorry if TMI)

I understand your concern about future tests, and you could ask to have your 6 month smear done with colposcopy mentioning your anxiety following your previous result. At least with colpsocopy they'll apply the stains etc. Hopefully your 6 month check will be clear. It's probably unlikely that you'll be able to have a colposcopy on the NHS for each smear with normal results, although you probably could privately.

Maybe have a chat with your GP about your worries? They may be able to arrange your 6 month check at the colposocpy clinic for you.

Take care and all the best x



Thanks so much for replying Twilight.

I have read that false negatives can be quite common and that's why screening is so regular.

Do you think the fact that i bled would have affected the results, as I saw the sample that he nurse collected and there was a lot of blood. I thought that would have meant it would come back inconclusive but obviously not.

My experience is that my smear test went off with quite a bit of blood on it and i was told at my gynae appt that due to this is would most likely be sent back as "inconclusive", however it wasnt, and i was referred to colposcopy as it had picked up the abnormal cells. 

Hi Precious,

If there was too much blood or not enough cells it would be generally be an inconclusive result. The bleeding may have led the nurse to be more gentle, and that in itself might mean that the sample didn't collect so many cells. 

Screening isn't perfect, the leaflets even say as much, which is why it's important not only to go for regular screening but to be body aware and to see a doctor if there are any problems or changes. They won't be anything serious most of the time but always best to be checked. Your surgery did the right thing in referring you as they were aware of the blood, which is a good thing, even if this whole experience is worrying.

Hi hon,

have you been told that your changes were glandular? Adenocarcenoma? That lurks further up the cervix and therefore can get missed in smears. 

Really look after yourself now and hopefully your body will fight it off for good. I wonder if you could have an HPV test too? 

Molly xx